Abstract Background: We aimed to assess the concordance of recommendation for initiating statin therapy according to the 2019 World Health Organization (WHO) cardiovascular disease (CVD) risk charts and to the presence of carotid plaque (CP) identified with carotid ultrasound in Mexican mestizo rheumatoid arthritis (RA) patients, and to determine the proportion of patients reclassified to a high cardiovascular risk after the carotid ultrasound was performed. Methods: This was a cross-sectional study nested of a RA patients’ cohort. A total of 157 Mexican mestizo RA patients were included. The cardiovascular evaluation was performed using the 2019 WHO CVD risk charts (laboratory-based model) for the Central Latin America region. A carotid ultrasound was performed in all patients. The indication to start statin therapy was considered if the patient was classified as high risk, moderate risk if > 40 years with total cholesterol (TC) > 200 mg/dl or LDL-C > 120 mg/dl, and low risk if > 40 years with TC > 300 mg/dl, according to the WHO CVD risk chart or if the patient had carotid plaque (CP). Cohen’s kappa (k) coefficient was used to evaluate the concordance between statin therapy initiation. Results: Initiation of statin therapy was considered in 49 (31.2%) patients according to the 2019 WHO CVD risk charts and 49 (31.2%) patients by the presence of CP. Cardiovascular risk reclassification by the presence of CP was observed in 29 (18.9%) patients. A slight agreement (k = 0.140) was observed when comparing statin therapy recommendations between 2019 WHO CVD risk charts and the presence of CP. Conclusion: The WHO CVD risk charts failed to identify a large proportion of patients with subclinical atherosclerosis detected by the carotid ultrasound and the concordance between both methods was poor. Therefore, carotid ultra-sound should be considered in the cardiovascular evaluation of RA patients.

The aim of this article is to present the medical and scientific literature (including an umbrella review) related to the use of face masks for the prevention of viral respiratory infections, to make an informed decision on the use of face masks during a pandemic. Since the beginning of the 20th Century, it was determined that the use of face masks is effective in reducing the transmission of respiratory infections. The first time face masks were used amongst the general public was during the 1918 Pandemic. Research on face masks during the 20th Century focused mainly on the effectiveness of the materials. It was determined that the best protection was achieved by using several layers of different close knit materials, preferably three. Meta-analyses showed that the use of face masks decreased the risk of contagion of respiratory viral diseases, including COVID-19, compared with not using them. Face masks protect both the user and other people in the population by limiting the exposure to SARS-CoV-2, minimizing the viral load, hence decreasing the risk of developing severe COVID-19. It has been established that any type of face mask is better than not using any mask at all. When deciding upon the use of face masks one should consider the risks and benefits. We conclude that there is sufficient evidence to support that the benefits of using face masks outweigh the risks.

El objetivo de este artículo es revisar la literatura médica y científica (incluida una revisión paraguas) relacionada con el uso de cubrebocas como medida de prevención en la transmisión de enfermedades respiratorias virales para tomar decisiones informadas durante una pandemia. Desde inicios del siglo XX se estableció que el cubrebocas es efectivo para reducir infecciones respiratorias.  El uso entre la población general inició hasta la pandemia de 1918. Desde entonces, las investigaciones se han enfocado principalmente en determinar los mejores materiales para su elaboración, encontrando que la efectividad del cubrebocas aumenta con el número de las capas, siendo ideal tres, de punto cerrado y de diversos materiales. Los meta-análisis demostraron que el uso de cubrebocas disminuye el riesgo de contagio de enfermedades respiratorias virales, incluido COVID-19, comparado a no usarlo. Los cubrebocas evitan el paso de una gran proporción de partículas del virus SARS-CoV-2 protegiendo tanto al portador como al resto de la población al reducir la carga viral a la que se está expuesto, disminuyendo así el riesgo de desarrollar enfermedad grave de COVID-19. Cuando las personas están en espacios públicos es preferible elegir usar cualquier cubrebocas, a no usar ninguna protección naso bucal. Para decidir sobre el uso del cubrebocas es importante evaluar el riesgo-beneficio. Con este análisis concluimos que según la evidencia, los beneficios del uso del cubrebocas superan los riesgos, por lo que recomendamos que el uso de cubrebocas de forma generalizada.